Obesity is a hot subject nowadays. Even literary journals speak about this matter: for example, in one of the latest issues of the New Yorker a lengthy book review by E. Kolbert is dedicated to the fattening of America (New Yorker, July 20, 2009). The number of books is really enormous: when clicking ‘obesity in America’ on Amazon.com I got 1351 results. However, in this vast flow of books and research articles, Obesity among Poor Americans would not stay unnoticed. First, because it looks at the obesity problem at a very special angle; second, because it gives a comprehensive, multidisciplinary outlook on the studied subject; and third, because of important recommendations for social policy makers.

The book opens with an introduction explaining its goals and design. The aim is to ‘… examine all of the available evidence’ in order to explain ‘… associations between obesity, poverty and public assistance’ (p. 6). The design is straightforward: there are six chapters in the book, the first one considering general trends while the following four chapters (from 2 to 5) discuss different models linking obesity and public assistance to find pro and contra arguments for the hypothesis of causal relationships.

In general (chapter 1), Smith states, there is some evidence linking participation in the public assistance program with adult obesity but the picture becomes more complicated when different models are considered. These four models are as follows: 1) public assistance causes obesity; 2) obesity causes public assistance; 3) poverty causes both; 4) factor X causes both.

Examining the evidence for the first model, the author concludes that special programs for food supplement in children do not lead to their higher obesity, while in adults there is a possibility that the Food Stamps Program is associated with higher BMI and increased obesity risk among women. However, this is not the reason to curtail the program but to revise it in such a way that participants would have more access to healthy food products.

Consideration of the second hypothesis gives some evidence that obesity increases the risk of poverty, particularly for white women, through barriers to better education, better jobs, marriages, etc. Two approaches may follow from this: to reduce obesity itself and to reduce its discriminative effects through establishing ‘… nationwide laws prohibiting employment discrimination on the basis of body weight’ (p. 68).

The third, most complicated model of ‘poverty causes both public assistance and obesity’ is examined in the fourth chapter. The author analyses six pathways that lead from poverty to obesity: through education; food availability and prices; food insecurity; stress and mental health (depression, etc); time preference; physical activity. Each topic is discussed at length (this is the longest chapter in the book) bringing evidence from many different disciplines: anthropology, economics, sociology, psychology, medicine and public health, etc. In conclusion it is stated that ‘poverty, both on the individual and community levels, influences food intake and physical activity and thus obesity status’ (p. 112), and recommendations for the government to prevent obesity among low-income citizens follow.

The ‘factor X’ hypothesis is discussed next. Among possible X factors, such as physical and intellectual disabilities, mental illness, physical and sexual abuse, and some others, the abuse factor seems to be associated with public assistance and obesity. So certain actions should be taken to reduce family violence and abuse, and the author gives a list of those suggested actions.

The final chapter gives an overall summary of the evidence and results, producing an important concluding table (Table 6.1) on causal pathways between public assistance and obesity. It also contains a strong appeal to academics to step out of their particular disciplines for an interdisciplinary approach that should bring a broader understanding of obesity, its causes and consequences for society. As a physical anthropologist I strongly support this appeal, and I think that the author, who is a professor of economics at the University of Michigan-Dearborn, has already made this important first step for the unification of different disciplines in her book.